Summary
A 13-year-old girl presented with infective endocarditis of the tricuspid valve related
to a residual ventricular septal defect. Antibiotic therapy produced a satisfactory
initial improvement, however, subsequent deterioration with uncontrolled infection,
in spite of alterations in the antibiotic regime, necessitated surgical intervention.
Because the endocarditis was localized to the septal leaflet, management by excision
of this leaflet and annuloplasty was possible and resulted in a rapid and sustained
clinical improvement with no evidence of significant residual valvar incomptence.
The medical management of infective endocarditis requires bacteriological assessment
to ensure that the drugs and dosages selected are appropriate and a adequate for the
causative organism. Early operation may be required for uncontrolled infection or
cardiac decompensation; in tricuspid endocarditis secondary to a ventricular septal
defect, the operation described permits removal of infective tissue while retaining
valvar competence.
Key words
Tricuspid valve - Infective endocarditis - Ventricular septal defect
